Abstract
Non-steroidal Anti-inflammatory drugs (NSAID)-exacerbated respiratory disease (N-ERD) is characterized by nasal polyposis, chronic rhinosinusitis, adult-onset asthma and hypersensitive reactions to cyclooxygenase-1 (COX-1) inhibitors. Among the available treatments for this disease, a combination of endoscopic sinus surgery followed by aspirin desensitization and aspirin maintenance therapy has been an effective approach. Studies have shown that long-term aspirin maintenance therapy can reduce the rate of nasal polyp recurrence in patients with N-ERD. However, the exact mechanism by which aspirin can both trigger and suppress airway disease in N-ERD remains poorly understood. In this review, we summarize current knowledge of aspirin effects in N-ERD, cardiovascular disease, and cancer, and consider potential mechanistic pathways accounting for the effects of aspirin in N-ERD.
Keywords:
COX-1 inhibitor; N-ERD; NSAIDs; aspirin; leukotrienes; lipoxins; nasal polyps; prostaglandins.
Copyright © 2021 Sehanobish, Asad, Barbi, Porcelli and Jerschow.
Publication types
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Animals
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Anti-Inflammatory Agents, Non-Steroidal / adverse effects
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Anti-Inflammatory Agents, Non-Steroidal / immunology
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Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
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Aspirin / adverse effects
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Aspirin / immunology
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Aspirin / therapeutic use*
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Asthma, Aspirin-Induced / diagnosis
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Asthma, Aspirin-Induced / immunology
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Asthma, Aspirin-Induced / metabolism
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Asthma, Aspirin-Induced / therapy*
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Desensitization, Immunologic*
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Disease Progression
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Drug Hypersensitivity / diagnosis
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Drug Hypersensitivity / immunology
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Drug Hypersensitivity / metabolism
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Drug Hypersensitivity / therapy*
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Humans
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Lung / drug effects*
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Lung / immunology
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Lung / metabolism
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Nasal Polyps / diagnosis
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Nasal Polyps / immunology
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Nasal Polyps / metabolism
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Nasal Polyps / therapy*
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Rhinitis / diagnosis
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Rhinitis / immunology
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Rhinitis / metabolism
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Rhinitis / therapy*
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Signal Transduction
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Sinusitis / diagnosis
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Sinusitis / immunology
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Sinusitis / metabolism
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Sinusitis / therapy*
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Treatment Outcome
Substances
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Anti-Inflammatory Agents, Non-Steroidal
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Aspirin